Corner Stitch

1. See Also
   1. Suture
   2. Local Anesthesia
   3. Laceration Repair
2. Indications: Skin flap closure (no vascular compromise)
   1. Y-shaped Laceration corners (90 degree angle)
   2. X-shaped Laceration
3. Advantages
   1. Does not compromise blood supply to tip of corner
4. Technique: Y-shpaed lesion
   1. Background
      1. Use non-Absorbable Suture
      2. Draw line perpendicular from corner tip (forms Y)
      3. Four landmark sites (2 on each side of the wound)
         1. Point 1 along left base of Y (6-8 mm from corner)
         2. Point 2 at left upper arm of Y (4 mm from corner)
         3. Point 3 at right upper arm of Y (4 mm from corner)
         4. Point 4 along right base of Y (6-8 mm from corner)
   2. Step 1: Skin entry to base of flap
      1. Enter at point 1 on left side of wound
      2. Needle passes deep, below Dermis
      3. Exits subcutaneously near Point 2
      4. Exits at point 2 on left side of wound
   3. Step 2: Subcuticular stitch through flap
      1. Continue stitch started in Step 1
      2. Enter wound at point 2 on left side of wound
      3. Pass subcuticular stitch in flap to point 3
   4. Step 3: Flap to skin exit
      1. Enter near point 3 still subcutaneously
      2. Exit skin at Point 4
   5. Step 4: Tie knot
      1. Knot is between point 1-4 across base of Y
      2. Tie snugly, but avoid tying too tightly
         1. See complications below
   6. Step 4: Final appearance
      1. Suture exposed between point 1 and 4
5. References
   1. Mortiere (1996) Wound Management, p. 50-5
   2. Snell in Pfenninger (1994), Mosby, p. 12-9
   3. Zuber (2002) Am Fam Physician 66(12):2231-6